DOI: http://dx.doi.org/10.3329/cbmj.v1i2.13857 Community Based Medical Journal Vol.1(2) 2012 8-13
A 5 week-old infant presented with fever and pallor for two weeks, reluctant to feed for one week and passage of bloody stool one time two days back. Child was found less active and severely anaemic with hepato-splenomegaly. Peripheral blood film showed marked leukocytosis with many immature cells which are mostly blast cell resembling lymphoblast containing one-two nucleoli. Bone marrow aspiration revealed findings suggestive of acute lymphoblastic leukemia. Other possibilities like neonatal sepsis and TORCH infection were ruled out and a final diagnosis of congenital leukemia was made. CBMJ 2015 July: Vol. 04 No. 02 P: 55-57
The lithopedion (Calcified abdominal pregnancy) is a rare phenomenon and there are less than 300 cases reported in the medical literature.In this case, a 35 year-old patient had her third pregnancy 8 years earlier without medical assistance since then she came to our hospital with low back pain. Complementary examinations (Abdominal X-ray, Ultrasonography and Color Doppler Ultrasonography) demonstrated an extra uterine abdominal about 25 - week pregnancy with calcified areas. Exploratory Laparatomy was performed, with extirpation of a well - conserved fetus with non calcified ovular membrane. DOI: http://dx.doi.org/10.3329/cbmj.v1i1.13852 Community Based Medical Journal Vol.1(1) 2012 33-34
Chronic kidney disease (CKD) has become a global public health concern. The adverse outcomes of CKD are enormous in developing countries due to paucity of facilities for renal replacement therapy and high cost of services for management of ESRD. Chronic kidney disease and its risk factors are common in Bangladesh, however community-based data on the subject is lacking. The purpose of this study to estimate and compare the prevalence of low GFR, proteinuria and associated risk factors using Cockcroft-Gault (CG) and Modification of Diet in Renal Disease (MDRD) equation based on serum creatinine (SCr) in a rural area of Bangladesh. An observational cross-sectional study performed on patients aged 18 years or older living in the rural area of Mymensingh were randomly selected from the database of the health care system and who gave informed consent to participate in the study. Subjects with nonresidents, pregnant, cognitive dysfunction that interfered with understanding and answering the study questionnaire were excluded from the study. The sample size was calculated with a formula for cross-sectional study and to meet the following criteria: a confidence level of 95%, acceptable error 15% and expected prevalence of CKD 15.7%. Therefore a sample size of 920 was considered appropriate for the study. The study was carried out for a period of 16 months between March 2014 and June 2015. Renal impairment was defined as eGFR less than 60 ml/min/1.73 m2. Thus stage 3, 4 and 5 of KDOQI were grouped as renal impairment. Renal function was estimated from serum creatinine using Cockcroft-Gault and MDRD (modification of diet in renal disease) equations. Data are presented as frequencies, percentages or mean ± standard deviation as appropriate. The Chi-square test was used for categorical variables and multivariate analyses was performed by binary logistic regression to identify the risk factors of CKD. All statistical tests were 2-sided. A p value lower than 0.05 was considered to be significant. All statistical analyses were done with SPSS Version 11.5 for Windows. Over half (51.7%) of the patients were male and rest 48.3% female with mean age 42.3 ± 13.2 years. Most (67.3%) of the patients were illiterate and only 22.8% engaged in salaried job. Over two-third (67.4%) of the patients were overweight and obese, 31.2% normal and very few (1.4%) underweight. The prevalence of low eGFR was 15.3% by Cockcroft-Gault and 15.9% by MDRD equation. The survey population had a 17% prevalence of proteinuria. Sex, illiterate, overweight & obese, obese by WC, hypertension, proteinuria, raised serum creatinine, diabetes mellitus, anaemia, family H/O CKD, low HDL cholesterol and raised total cholesterol were found to be the independent predictors of CKD. The prevalence of low eGFR in this rural population is common and an increase prevalence of proteinuria. The association between CKD and risk factors was also highly significant. There is an urgent need for more detailed measurement for these risk factors through a comprehensive survey to evaluate individuals with risk factors, to enable earlier detection and risk factor reduction through rising of awareness. CBMJ 2016 July: Vol. 05 No. 02 P: 04-13
Umbilical hernia is one of the most commonly encountered abnormalities in early months of infancy and childhood. Though umbilical hernia is a common benign condition which resolves spontaneously during first 5 years of life, it may be a great concern to the parents and other caregivers. Therefore, the high index of suspicion, prompt recognition and thorough understanding of common factors are necessary to ensure their correction and convince the parents to treat. A hospital based cross sectional observational study was conducted in the paediatrics unit of Community Based Medical College & Hospital from March 2013 to September 2013 to determine the factors associated with umbilical hernia. A total of 160 cases of umbilical hernia admitted in paediatrics unit and outpatient department of Community Based Medical College & Hospital were enrolled in the study. Necessary information were collected by detailed history taking, clinical examination and close follow up of the hospital course, using pre-designed questionnaire. Among 160 patients, malnutrition were observed in 21.8% , severe malnutrition was the most common abnormality (45%) followed by moderate malnutrition 28.05%, mild malnutrition 28.05%. Low birth weight were found to have 21.3%, among medical condition, excessive crying were 18.7%, chronic cough were 18.7%, constipation were 17.5%, positive family history 1.9%. Malnutrition and low birth weight are more common association of umbilical hernia.Malnutrition has great impact on developing umbilical hernia. Chronic cough, excessive crying, constipation more or less equally responsible. So early identification of risk factors and proper management and close monitoring are important to reduce the risk of developing umbilical hernia. CBMJ 2018 July: Vol. 07 No. 02 P: 04-08
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